Educating women is the key to lowering maternal mortality, says major new international study

The fifth Millennium Development Goal (MDG) put forward by the United Nations (MDG-5) proposes to reduce the world's maternal mortality ratio by 75%, by 2015.

But what is the best way of doing this?

International programmes sponsored by the UK and US governments, and delivered under the auspices of international organisations like the UNFPA (UN Population Fund) and IPPF (International Planned Parenthood Federation), focus on the provision of contraception and ‘safe’ abortion as key priorities.

However a new 50 year follow-up study from Chile has literally blown that hypothesis out of the water and demonstrated that the key determinant of maternal mortality is actually the educational level of women.

Furthermore, one of the most significant findings is that, contrary to widely-held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction).

The result is that Chile is now doing better with maternal mortality than the United States.

Chile offers an opportunity to investigate the influence of these determinants on maternal mortality trends. Not only are large time series of vital and socioeconomic data available for this country that are of similar quality to those of developed countries, but legislation prohibiting therapeutic abortion was passed in 1989.

As a result, data from Chile provide a rare and unique natural experiment to evaluate the influence of population factors, the legal status of abortion and other historical policies on maternal mortality trends since data are available before and after interventions were implemented.

Another recent report has shown how Ireland and Northern Ireland benefit significantly from their near complete ban on abortion in a number of ways.

The report, 'Ireland’s Gain', links Ireland’s low abortion rate to low incidences of breast cancer and comparative good mental health among women when compared with those in England, Scotland and Wales.

The implications for international policy are clear, but will the lavishly funded birth control and abortion industry take note?

I’ve reproduced below the press release from AAPLOG about the Chilean study which gives more of the detail.

Chile Outperforms US and Dramatically Reduces Maternal Deaths by Increasing Women’s Educational Level

A scientific analysis of 50 years of maternal mortality data from Chile has found that the most important factor in reducing maternal mortality is the educational level of women.

‘Educating women enhances women’s ability to access existing health care resources, including skilled attendants for childbirth, and directly leads to a reduction in her risk of dying during pregnancy and childbirth,’ according to Dr Elard Koch, epidemiologist and leading author of the study.

The research entitled ‘Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: a Natural Experiment in Chile from 1957 to 2007’ was conducted on behalf of the Chilean Maternal Mortality Research Initiative (CMMRI) and published in the Friday, May 4 issue of PLoS ONE.

Using 50 years of official data from Chile’s National Institute of Statistics (1957-2007), the authors looked at factors likely to affect maternal mortality, such as years of education, per capita income, total fertility rate, birth order, clean water supply, sanitary sewer, and childbirth delivery by skilled attendants. They also analyse the effect of historical educational and maternal health policies, including legislation that has prohibited abortion in Chile since 1989, on maternal mortality.

During the fifty-year study period, the overall Maternal Mortality Ratio or MMR (the number of maternal deaths related to childbearing divided by the number of live births) dramatically declined by 93.8%, from 270.7 to 18.2 deaths per 100,000 live births between 1957 and 2007, making Chile a paragon for maternal health in other countries. ‘In fact, during 2008, the overall MMR declined again, to 16.5 per 100,000 live births, positioning Chile as the country with the second lowest MMR in the American continent after Canada and with at least two points lower MMR than United States’ said Koch.

One of the most significant findings is that, contrary to widely-held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction). ‘Definitively, the legal prohibition of abortion is unrelated to overall maternal mortality rates’ emphasized Koch.

The variables affecting this decrease included the predictable factors of delivery by skilled attendants, complementary nutrition for pregnant women and their children in the primary care clinics and schools, clean facilities, and fertility. But the most important factor and the one which increased the effect of all others was the educational level of women. For every additional year of maternal education there was a corresponding decrease in the MMR of 29.3 per 100,000 live births.

The picture for Chile includes a transition of leading causes of death along with an accelerated decline of fertility and delayed motherhood. Koch explained that direct causes –those directly attributable to pregnancy condition– were the rule before 1990, but from then, indirect causes –ie. non-obstetric chronic conditions such as hypertension and diabetes among others– rise as the most prevalent, hindering the decline on maternal mortality.

‘This study uncovers an ongoing “fertility paradox” in maternal health: education is the major modulator that has helped Chile to reach one of the safest motherhood in the world, but also contributes to decrease fertility, excessively delaying motherhood and puts mothers on risk because of their older age.’ Thus, an emerging problem nowadays ‘is not a question of how many children a mother has, but a question of when a mother has her children, specially the first of them’ concluded Koch.

Press Release from American Association of Pro Life Obstetricians and Gynecologists (AAPLOG)

A more complete statement on the study by the study's author is available here

Conclusion by Elard Koch, the main author

Taken together, the Chilean natural experiment over the last fifty years suggests that the progress on maternal health in developing countries is a function of the following factors: an increase in the educational level of women, complementary nutrition for pregnant women and their children in the primary care network and schools, universal access to improved maternal health facilities (early prenatal care, delivery by skilled birth attendants, postnatal care, availability of emergency obstetric units and specialized obstetric care); changes in women's reproductive behaviour enabling them to control their own fertility; and improvements in the sanitary system ie. clean water supply and sanitary sewer access. Furthermore, it is confirmed that women's educational level appears to have an important modulating effect on other variables, especially promoting the utilization of maternal health facilities and modifying the reproductive behaviour. Consequently, it is proposed that these strategies outlined in different MDGs and implemented in different countries may act synergistically and rapidly to decrease maternal deaths in the developing world.

Fantastic treatment breakthrough highlights utter scandal of British banking crisis

Here is an amazing good news story I first read about on Aljazeera which has had wide coverage outside the UK but has been largely ignored by the BBC and most British newspapers.

I have previously highlighted on this blog that by focussing exclusively on HIV/AIDS, malaria and TB, Western governments and NGOs have neglected other easily treatable and curable diseases.

The neglected diseases, which include schistosomiasis, river blindness, ascariasis, elephantiasis and trachoma, affect more than 750 million people and kill at least 500,000 every year.

Treating all of these illnesses with a cocktail of four readily available drugs would cost less than 50 cents (28p) a person a year. Furthermore dealing with the forgotten diseases would reduce susceptibility to malaria and help to make socio-economic improvements for those in poverty, as well as save lives.

Reaching everyone in Africa who needed treating would cost $200 million a year, a mere fraction of the $15 billion a year being spent on malaria, HIV and TB.

But this week a fantastic breakthrough has been announced.

Thirteen major pharmaceutical companies, government groups and health charities will work together in a push to eliminate or control by 2020 ten tropical diseases that affect more than a billion people in poor countries.

The partners, including the Bill & Melinda Gates Foundation, call it the largest coordinated effort ever to combat neglected tropical diseases. The government groups and charities alone are committing just over $785 million in new funding.

The drug makers are donating billions of doses of their medicines over the rest of the decade, but did not attribute a value to them. The companies also will work together to speed up development of new treatments, and the partners will work on improving drug delivery and treatment programs, including prevention and education.

The project, announced Monday at the Royal College of Physicians in London, aims to meet the goals of the World Health Organization's roadmap for controlling the diseases by 2020.

The Bill & Melinda Gates Foundation is the project’s biggest donor, with a five-year, $363 million donation to support research and operations. The U.K. Department for International Development is committing about $305 million, and the U.S. Agency for International Development is providing $89 million. That's on top of USAID’s $212 million investment since 2006. Other governments or charities are giving smaller amounts.

This is wonderful news indeed but in reading the main thing that struck me was the miniscule cost of this project alongside the scale of our British national debt.

I have previously also remarked that the cost of tackling non-communicable diseases (eg. heart disease, cancer, chronic respiratory disease and diabetes) worldwide each year in poor countries is less than 1% of what we spent bailing out British banks.

This cost, calculated at £7.2 billion, is more than ten times what has been pledged this week but less than 1% of what we will spend bailing out British banks (£850 billion). Much has been made of the £45 billion of taxpayers money used to bail out Royal Bank of Scotland (RBS). But this £850 billion total is almost 20 times that.

According to the National Audit Office the Government spent £117 billion buying shares in banks and lending directly to financial institutions.

The audit office also suggested that the bill could rise further, as the total of investments, guarantees, loans and insurance schemes established to support the banks meant that the taxpayer was liable for up to £850 billion - £40,000 for each family.

The £850 billion includes buying £76 billion of shares in Royal Bank of Scotland and the Lloyds Banking Group; indemnifying the Bank of England against losses incurred in providing more than £200 billion of liquidity support; guaranteeing up to £250 billion of wholesale borrowing by banks to strengthen liquidity; providing £40 billion of loans and other funding to Bradford & Bingley and the Financial Services Compensation Scheme; and insurance cover of over £280 billion for bank assets.

Given how little it costs in comparison to prevent, treat or eliminate disease imagine what impact we could have made had we chosen to invest our money in caring for the poor rather than in borrowing to live beyond our means!

Perhaps this is one reason why the former Archbishop of Canterbury, George Carey, recently said that Britain’s public debt, which last month topped £1 trillion, was the ‘greatest moral scandal’ facing the country.

God said of Sodom, ‘Now this was the sin of your sister Sodom: She and her daughters were arrogant, overfed and unconcerned; they did not help the poor and needy. They were haughty and did detestable things before me. Therefore I did away with them as you have seen.’ (Ezekiel 16:49, 50)

If this was what he thought of Sodom, I wonder what he thinks of us.

Send a gift this Christmas that will really transform lives in the developing world

Do you feel you are just going through the motions this Christmas spending money on unneeded gifts?

Some friends told me last year that they had given each of their children a £50 allowance to buy Christmas gifts for people living in developing countries.

Their kids had grasped the opportunity with both hands, putting careful thought into their purchases, and even adding some of their own savings in an effort to make a real difference in the lives of those they were seeking to help.

The idea of 'buying a goat for Christmas' is not new but it is amazing to see the huge variety of other gifts that are now available on line. And for not much outlay at all.

On the Christian Aid site you can buy 5 mosquito nets for £15, a beehive for £12, and a 'wormery' for £7. 16 ducks go for £25 and a goat for £15.

Samaritan's Purse is offering four chickens for £10, a latrine for £15 or four blankets for £14.

From CBM £26 will provide enough Mectizan tablets to help 40 families for an entire year - stopping the progression of River Blindness (Onchocerciasis) and freeing them from the associated, debilitating symptoms. £15 will protect 50 children for 6 months from vitamin A deficiency and related loss of sight.

World Vision is offering piggeries (£60), llamas (£46) and sewing machines (£98).

These are just a few of the hundreds of imaginative options on these sites and others like Oxfam and Save the Children.

Why not make someone you have never met feel special this Christmas.

Sell your possessions and give to the poor. Provide purses for yourselves that will not wear out, a treasure in heaven that will never fail, where no thief comes near and no moth destroys.(Luke 12:33)

The real answer to reducing maternal mortality is not 'safe' abortion but better education, obstetric and midwifery care, CMF tells DFID

The Christian Medical Fellowship has now published its submission to the Department for International Development (DFID) Consultation on Maternal Health Strategy: 'Choice for women: wanted pregnancies, safe births'

The Government proposals have been criticised for appearing to link the provision of abortion services with international development aid as DFID says one of its key proposals is ensuring access to contraception and ‘safe’ abortions.

By contrast the CMF submission tackles the problem in an evidence-based way reviewing the real causes of maternal mortality and the interventions that have been shown in practice to reduce it.

It concludes that the real solution to maternal mortality is multi-level: addressing social attitudes, education and empowerment and good quality obstetric and midwifery care and better birth spacing.

Furthermore this is best achieved through positive engagement with religious leaders, communities and faith based organisations (FBOs).

The whole submission is available on the CMF website but its main points are as follows:

1. In the last two decades we have seen a marked reduction globally in maternal mortality from 500,000 deaths per annum to 350,000 per annum. The vast majority of these are still in the developing world.

2. The interventions that have reduced this mortality rate have been multi-level: addressing social attitudes towards women, pregnancy and child birth; providing education for girls and the empowerment of women; increasing access to good quality obstetric and midwifery care (in the local community and in accessible secondary care institutions); and providing family planning services to allow better birth spacing, etc. We hold that the evidence suggests that only such multi-level interventions will have significant or lasting success in tackling maternal mortality; and further, that strengthening health systems for maternal health will have collateral benefits for other areas of health need.

3. Positive engagement with religious leaders, communities and faith based organisations (FBOs) is vital, as they are not only significant providers of services, but also hold the key to challenging and changing social attitudes and values that can devalue women and their health needs.

4. Empowering women, and changing socio-cultural and religious values that disenfranchise women and girls and deny them access to healthcare and education, are priorities. This requires engagement with community leaders in general, and religious leaders and communities in particular, in their own terms and context, rather than imposing Western worldviews and values.

5. Single issue interventions are damaging to wider health needs in the long term. We advocate strengthening the broad range of health infrastructure and provision (both primary and secondary) in developing nations. This includes appropriate training (undergraduate and postgraduate), professional support for healthcare staff, and adequate provision of properly maintained equipment with appropriate supply chains.

Richard Stearns’ huge Lausanne challenge to the church of America about its attitude to wealth, poverty and power applies equally to us in the UK

The churches in the more prosperous northern hemisphere, in particular, need to return to the gospel of Christ. That gospel is not just about individual salvation, but a life transformation that results in compassion, service and a striving for justice.

This was the message that Richard Stearns, President of World Vision United States, brought in what I thought was one of the defining events of the Cape Town 2010 Lausanne Congress on 24 October. He argues that there is ‘a hole’ in our Gospel.

The video is only 15 minutes long but worth every second. Share it with your friends, show it in your house groups and churches and help spread this message right from the heart of God.

You can watch the whole address on line but I have excerpted some of the highlights below to whet your appetite.

For a much fuller treatment of the underlying issues you can read Richard’s new book (2010 Christian book of the year!), ‘The Hole in our Gospel’.

The full title says it all, ‘The Hole in Our Gospel: What does God expect of Us? The Answer that Changed my Life and Might Just Change the World’.

Wealth, Poverty and Power - The Hole in our Gospel (transcript)

‘When Jesus read the scroll of Isaiah in the synagogue at Nazareth he proclaimed the stunning truth that he was the Messiah and that he had come to preach the good news to the poor, the good news that man could be reconciled to God through the death and resurrection of his Son. But Jesus did not stop there at proclamation. He also spoke of restoring sight for the blind, freeing the captives and oppressed, proclaiming the year of the Lord’s favour. It was a reference to the year of Jubilee instituted by God to promote economic justice and to prevent economic exploitation and disparity.

Jesus described a big Gospel, a Gospel that began with proclamation and evangelism, yes, but also embraced compassion toward our fellow man and biblical justice – proclamation, compassion and justice – you see these three defined the good news of Jesus Gospel. These three were the coming signs of Jesus coming on earth. These three were the revolutionary truths that would change the world as we know it and help us claim it for Christ.

The whole Gospel makes demands upon the rich and the poor that go beyond belief. This whole Gospel means a total surrender to God’s kingdom, not just believing the right things but doing the right things as well.

We are called to care for the widow, the orphan, the alien and the stranger. We’re called to lift up justice and fight economic disparity; to speak up for the voiceless and to hold our governments accountable; to challenge racism and bigotry; to be generous with our money and to live lives of integrity before a watching world.

The most powerful evangelism of all involves not just speaking the good news but being the good news. Not just preaching the Gospel but demonstrating the Gospel because love for our neighbours that is only spoken is not love at all. You see love must be demonstrated.

This radical gospel of love, word and deed was intended by Jesus to launch a social and spiritual revolution on earth, one that had the power to change the world. And we were to be on the front lines of that revolution, we the church. That was the plan. Jesus called that the coming of the Kingdom of God and it was meant to be good news for the entire world.

But sadly the church over the centuries has often failed to be that good news…

What about our generosity? In the wealthiest of all nations in Christian history we give just 2.5% of our incomes to God’s work, 75% less than the biblical tithe. And 98% of what we give is spent in the United States – 98% for us and 2% for the rest of the world.

“I was hungry while you had all you needed. I was thirsty but you drank bottled water. I was a stranger and you wanted me deported. I needed clothes but you needed more clothes. I was sick but you pointed out the behaviours that led to my sickness. I was in prison and you said I was getting what I deserved.”

This is the version of Matthew 25 that many Americans and even churches have embraced.

I believe that the American church stands at a crossroads. The world we live in under siege. Three billion are desperately poor, one billion hungry, millions are trafficked in human slavery. Ten million children die needlessly every year. Wars and conflicts are wreaking havoc. Pandemic diseases are spreading and ethnic conflict is flaming. Terrorism is growing. Most of our brothers and sisters in the developing world live in grinding poverty. And in the midst of this stands the church in America with resources, knowledge and tools unequalled in the history of our faith.

I believe we stand on the brink of a defining moment and have a choice to make.

When historians look back in 100 years what will they write about this nation of 340,000 churches? What will they say of the churches response to the great challenges of our time; AIDS, poverty, hunger, terrorism and war?

Will they say that these authentic Christians rose up courageously and responded to the tide of human suffering to comfort the afflicted and douse the flames of hatred? Will they speak of an unprecedented outpouring of generosity to meet the needs of the world’s poor? Will they speak of the moral leadership and compelling vision of our leaders? Will they write that this, the beginning of the 21st century, was the churches’ finest hour?

Or will they look back and see a church too comfortable and insulated from the pain of the rest of the world, empty of compassion and devoid of deeds? Will they write about a people who stood by and watched while a hundred million died of AIDS, and 50 million children were orphaned, of Christians who lived in luxury and self indulgence while millions died from a lack food and water?

Will school children write and discuss about a church who had the wealth to build great sanctuaries but lacked the will to build hospitals, schools and clinics? In short will we be remembered as the church that had 'a hole in its Gospel'?

I want you to imagine just for a moment what would happen if we in the Christian community really stepped up to God’s call to take the good news to the ends of the earth. What if our wealthy churches turned their faces outward away from their big sanctuaries, PowerPoint screens and praise music and turned their faces toward the pain and brokenness in our world? What if we brought the whole tithe into the storehouse and embraced the whole Gospel?

Sometimes I dream and I ask "What if?" What if we actually took this Gospel seriously? Could we, might we, actually be able to change the world? As I close let me read you an imaginary press release from the United Nations dated 2025…’

(for the rest of this address watch the full fifteen minutes of Richard Stearns Cape Town 2010 address ‘Wealth, Poverty and Power - The Hole in our Gospel’ )

Jesus’ Nazareth Manifesto as a basis for healthcare mission

Jesus Christ’s dynamic entry into first century Palestine was marked by miraculous healing of many illnesses for which even today there are no known treatments. But along with his compassion to restore health he brought the gospel message of healing of broken relationships - between human beings, between human beings and the planet and most crucially between human beings and God.

Luke, probably the first ever Christian doctor, tells us that Jesus sent his followers out ‘to preach the kingdom of God and to heal the sick’(Luke 9:2). Right from the beginning ministry to the spirit and ministry to the body have gone hand in hand.

For the last 2,000 years, Christian doctors and nurses, inspired by the example and teaching of Jesus, have been at the forefront of efforts to alleviate human suffering, cure disease, and advance knowledge and understanding.

Many of medicine’s pioneers were men and women who had deep Christian faith: Pare, Pasteur, Lister, Paget, Barnado, Jenner, Simpson, Sydenham, Osler, Scudder, Livingstone and many more.

In the 21st century, whiles some avenues for missionary work are closing, others are opening wide. Christian health professionals, and particularly doctors, have a passport to limited access and creative access countries that those of many other professions do not. But what is their mandate and what should be their priorities in playing the part in fulfilling Jesus’ great commission?

Jesus’ Nazareth manifesto in Luke 4 provides a biblical basis for healthcare mission.

We are told that when standing to read in the synagogue on the Sabbath in his home town, he was handed the scroll of the prophet Isaiah and ‘found the place where it is written’:

The Spirit of the Lord is upon me, because he has anointed me to preach good news to the poor. He has sent me to proclaim freedom for the prisoners and recovery of sight for the blind, to release the oppressed, to proclaim the year of the Lord’s favour (Luke 4:18,19)

The Jews listening would have recognised this quote from Isaiah 61, which actually ends, ’And the day of vengeance of our God’ (Isaiah 61:1,2). Jesus didn’t read these words but stopped mid-verse presumably to illustrate that redemption and judgment were going to be separated in history. Judgment would be delayed in order to allow people to repent. The Jews didn’t understand God’s mercy in delaying judgment, his love or the scope of his redemptive plan.

The manifesto starts, ’The Spirit of the Lord is upon me, because he has anointed me’. Elsewhere Jesus says, ’As the Father has sent me, I am sending you... Receive the Holy Spirit’ (John 20:21,22)

It goes on to reveal Jesus’ four-fold ministry, which is to be our own model: preaching, healing, deliverance and justice.

(Excerpted from paper delivered at a dialogue session at the Third Lausanne Congress, Cape Town 2010. The full text is available on the Lausanne Conversation Website)

Fantastic interview! Rev Cooper, chaplain to Chile’s president, gives glory to God on Radio Five Live about God’s hand in rescue of Chilean miners

Reverend Alfredo Cooper, chaplain to Chile’s president, was interviewed this afternoon about the rescue of the Chilean miners on Radio Five Live’s Drive programme by presenter Peter Allen.

Cooper took the opportunity with both hands to give the full glory to God, delivering a wonderfully clear and gracious testimony about the power of prayer. You are very unlikely to read the following transcript in any newspaper, so enjoy!

The discussion took place just after 5pm and you can now hear it on you tube or on the Christian Institute website.

Peter Allen: ‘Actually there was one gentleman I got a chance to talk to a little bit earlier. He’s the Reverend Alfredo Cooper. I’ll be absolutely honest with you. We heard an English voice down the line and in fact this gentleman apparently had turned up to thank the British press for what they’d done with this whole event and when they heard his English voice we got him in front of the microphone. He’s called the Reverend Alfredo Cooper. He’s actually chaplain to the country’s president and he told me when he first got involved in the aftermath of the mine’s collapse.’

Rev Cooper: ‘I am a chaplain in the presidential palace and so we had to quickly put together an emergency prayer meeting and it was with all our hearts because to imagine these 33 men a kilometre under the earth not knowing whether they were alive or what was going through their minds.17 days we prayed and then the miracle came when the boring machine glanced off a rock and hit them – hit the cavern they were in - and of course we just erupted in praise. The second service the president called for was a praise meeting so we had a thanksgiving service and since then we’ve had constant prayer. And this has been one of the interesting factors for folk like us to notice. Many of the miners went down as atheists, unbelievers or semi-believers and they have come up to a man testifying that they were not 33 but that there were 34 down there - that Jesus was there with them and that they had a constant sense of his guidance and presence.’

Peter Allen: ‘If you truly believe that it was divine intervention that rescued then presumably you believe that it was divine intervention that left them down there in the first place. I mean it doesn’t always make sense this kind of (chuckles) argument does it?’

Rev Cooper: ‘Well the thing is that in this fallen world this is exactly what does occur. Man is subject to accidents and all sorts of problems thanks often to his wilful negligence as was the case in this mine. There are consequences when you don’t care enough for people. And of course in those situations we might compare Jonah in the whale - you know people tend to cry out to God and this is what’s happened. And God has answered.’

Peter Allen: ‘So you believe God listened to your prayers? God listened to your prayers - God listened to their prayers. You believe they were rescued by divine intervention really?’

Rev Cooper: ‘Well of course we see the hands of all these magnificent experts all around, the good will of so many people internationally and the brilliant coverage of the press and we would suggest that all this works together for good, that certainly as we prayed God has guided in remarkable ways – even the scientists. I was with the NASA people who came the other day. And to my surprise - to a man they were believing scientists in their case - and they all said “This was a miracle. There is no other word for what happened here”.’

Peter Allen: (mumbling and sounding a bit uncomfortable)

Rev Cooper: (really getting into it now!) ‘So you know - Scientists, politicians, presidents - we’ve all come together in one happy moment saying, “Goodness! God is there and he answers prayer.” That’s how we feel. And certainly the miners are also testifying to the world of this - not just about that but certainly it seems to be a central factor.’

Peter Allen: ‘That’s the religious perspective from the Reverend Alfredo Cooper. It’s 5.15pm.’

I waited patiently for the LORD; he turned to me and heard my cry.
He lifted me out of the slimy pit, out of the mud and mire;
he set my feet on a rock and gave me a firm place to stand.
He put a new song in my mouth, a hymn of praise to our God.
Many will see and fear and put their trust in the LORD.
Blessed is the man who makes the LORD his trust.
(Psalm 40:1-4)

As UK Christian doctors, are we as radically different from non-Christians in our attitudes and actions as our Indian colleagues are?

I paid for my trip to India in stress and sweat. Not out there, but in the mad rush to clear my desk before departure, and in the bulging in-tray and looming deadlines on return. However the blessing I received in ten autumn days, through being involved in the EMFI national conference and in visiting hospitals and health projects in the northwest, was well worth it. There is much to tell, but let me share the three things that struck me most.

The first was a sense of thanks for the blessings Christianity has brought in Britain. We easily forget that we have clean drinking water, low infant mortality, few street children, minimal corruption, good health and education, a functioning legal system and a good standard of living largely as the legacy of Christian revival in the18th and 19th centuries. What Wesley and Whitefield sparked in the 1700s led ultimately to profound social reform through notables like Wilberforce, Barnardo and the Clapham sect. Our medical system too is indebted to the foundation laid by Christian doctors like Lister, Jenner and Sydenham and most of our present difficulties are because we have forgotten as a society what once made us great. By contrast, India’s principle problem is a suffocating ideology which stratifies people into castes, values cows more than children and promotes spirituality without morality. Hinduism has two main failings: it isn’t true and it doesn’t work.

The second thing that struck me was a sense of wonder at what God is doing today in India. There are now over 40 million Christians, and 44,000 Indian missionaries serve cross-culturally within its borders. Past missionary efforts have led to the Syriac church in Kerala, the Catholic Church around Goa and the Protestant churches in the northeast and south-east tip, in the 1st, 15th and 19th centuries respectively. In some states Christians now make up over 80% of the population. But all these past incursions of God’s spirit are being dwarfed by the current wave of new converts, from all backgrounds, but especially amongst the poor. I met new Christians who were formerly Jain, Animist, Sikh and high-caste Hindu and visited areas where Buddhist and Muslims are coming to Christ. There is a real sense of expectancy amongst the churches and doors are wide open.

But third, I was most challenged by the way many of our Christian doctor colleagues integrated their faith and lifestyle, particularly in their concern for the poor. The Evangelical Fellowship of India (EMFI), our sister organisation, is growing rapidly, and has been built on a firm foundation of sacrificial and compassionate service to those in most need. There are still over 1,200 church hospitals in India largely staffed by Indian Christian doctors, many of whom trained at one of two Christian hospitals, Vellore and Ludhiana. Most are in areas where Christians are fewest in number, and through associated urban and rural community health, literacy and development projects, are empowering marginalised people and transforming communities. One team of 70 healthcare professionals, in ten years, had helped transform the lives of 200,000 of Delhi’s slum dwellers to the extent where child mortality had fallen 80% and there was 95% immunisation, almost full employment and minimal malnutrition or TB. Pregnant women received antenatal care of almost UK standards (including ultrasound) and in one site I visited most of the houses had metered electricity, many with electric fans and televisions. What the Christians do provides the opening for what they say. In the same way, in the aftermath of the Orissa floods and the Gujerati earthquake, Christian compassion through healthcare has opened up to the gospel those regions most antagonistic to Christianity.

I wonder if, as Christian doctors in the UK, we are as radically different from non-Christians in our attitudes and actions as our Indian brothers and sisters are. And if not, what effect it has on how the gospel is received by our patients and colleagues.

Helping Haiti

Following the devastating earthquake that struck Haiti on Tuesday 12 January, causing tragic loss of life and massive destruction, CMF members have been asking how they should respond to this disaster.

The UK Department of Health reports that the initial acute medical response is now well underway with 14 field hospitals, one US hospital ship and 800 Cuban doctors. The UN Disaster Assessment and Coordination (UNDAC) Team leader has announced that other than those teams already en route, no further Search and Rescue (SAR) teams are currently required.

CMF is therefore encouraging members primarily to:

1. Pray for all involved

2. Give via the following routes:
Disasters Emergency Committee (DEC) - representing UK agencies responding
International Health Partners - supplying drug packs
CMDA - our US sister organisation

The Department of Health has advised that individuals should not try to go to assist unless registered with an agency which is part of the Global Health Cluster response. However, if you have the appropriate language (French), skills and experience you can contact aid agencies for inclusion on their roster:
Médecins Sans Frontières
Merlin
Save the Children

Meanwhile regular updates are available on the evolving situation at:
BBC
DFID
WHO

In the midst of this tragedy there are encouraging reports of local Christians being at the forefront of aid and relief, and of Christians praising God in the disaster:

God is our refuge and strength, an ever-present help in trouble (Psalm 46:1)

Goats and kitchen sinks for Christmas

Some friends told me this week that they had given each of their children a £50 allowance this year to buy Christmas gifts for people living in developing countries. Their kids had grasped the opportunity with both hands, putting careful thought into their purchases, and even adding some of their own savings in an effort to make a real difference in the lives of those they were seeking to help.

The idea of 'buying a goat for Christmas' is not new but it is amazing to see the huge variety of other gifts that are now available on line. And for not much outlay at all.

On the Christian Aid site you can buy mosquito nets, school shoes, beekeeping hats and 'wormeries' all for less than £20; 16 ducks go for £25, a tap, toilet and sink for £41 and £96 pays a term's salary for a teacher.

Samaritan's Purse is offering six chickens for £15, a latrine for £30 or a water cooler for £40.

From CBM £26 will provide enough Mectizan tablets to help 40 families for an entire year - stopping the progression of River Blindness (Onchocerciasis) and freeing them from the associated, debilitating symptoms. £20 will restore sight for someone blinded by cataracts.

World Vision is offering herds of goats (£80), flocks of sheep (£120), llama breeding pairs (£90) and trees in lots of 27 (£81).

Other options altogether are being put up by Wateraid, Oxfam and Save the Children.

This service that you perform is not only supplying the needs of God's people but is also overflowing in many expressions of thanks to God. (2 Corinthians 9:12)